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~ Children, Adolescents & Grief ~
Children haven’t had many of the experiences life has to offer, nor are they cognitively able to understand death as we [adults] do. Thus they grieve without the same level of comprehension of what is happening to them, for they have not had the experience of the finality that accompanies someone’s death.
Helen Fitzgerald, The Grieving Child

Children's losses are often invalidated with many incorrectly believing that they are too young to experience loss or a grief response. Children and adolescents react differently to death, loss and traumatic events because they have not had many of the life experiences of adults. They will express their grief in a variety of ways and may even appear to be unaffected by the death. Because children and teens grieve differently than adults, their needs, especially support through the grieving process, are often overlooked. Consequently, children and teens are frequently forgotten, even invalidated, as mourners.

Reactions to loss & death depend on where a child or adolescent is developmentally. Young children (preschool) have problems understanding that death is not a temporary, reversible event; this belief is reinforced by movies, cartoons and television. Older children (5 - 9) begin to experience grief more like adults and have a better understanding of death as a permanent state, but they still believe that death will not happen to them or any of their loved ones.

A child's first experience with death is often the death of a pet. Children also can encounter the death of grandparents, parents, siblings, teachers, friends and schoolmates. Even without experiencing death firsthand, children and adolescents are exposed to loss, dying, death and grief merely by living--whether it is listening to music, playing games, or watching television or movies. Children may face other losses through divorce, relocation or even with growing-up. As children age they must adapt to many different losses including the loss of childhood, loss of friendships, loss of identity, loss of roles, loss of self-esteem. Unfortunately, with the emphasis on growing up so soon now, children often face a loss of innocence.

A loss, crisis, significant life change or death, particularly if sudden, tragic or unexpected may precipitate a grief response that can overwhelm an adult's normal ability to cope. This can be manifest as an unavailability to support children emotionally or even carry out their normal child care responsibilities. Children, especially the young, have a sixth sense that enables them to sense an adult's fear and anxiety. As adults struggle to deal with their responses and grief, they must remember that children and adolescents will turn to them for help. It is important to remember that children learn their responses to loss and how they will cope from their family.

Children's Reactions are Dependent on Many Factors
During times of loss children turn to their parents, their teachers and other trusted adults for help, answers and guidance. Parents and teachers can help children and young adults avoid or overcome emotional reactions that may result following a tragedy by creating and open environment, being there ready to listen and answer questions and providing support. Being comfortable with discussing the death, or events with children is important. (See "How to Talk to Children") How a parent or other adult react to a child following a loss, death or any traumatic event can aid (or hinder) in his/her recovery process.

Children's response to a loss, death or tragedy depends upon many different factors.

  • The cause and type of death, event or tragedy.
  • The child's age, sex and developmental stage.
  • The nature of the relationship to the lost object.
  • The manner in which the child is informed of the loss.
  • How well the child is prepared for the death, if anticipated.
  • The child's mental health prior to the loss or death.
  • The reality, honesty and scope of the information given to the child.
  • The openness of the environment to allow and promote discussion of the topic.
  • The nature and availability of a support system.
  • Parents, family and other significant adult's ability to acknowledge and role model grieving.
  • The child's self-esteem.
  • The availability of a stable household and/or adults.
  • The families ability to adjust to the loss and keep on living.
  • Familial support, understanding and acknowledgment of the child's emotions—anger, fear, sadness, guilt and depression.
Normal, Common Grief Responses in Children & Adolescents
Parents, caregivers, teachers and other adults that are dealing with children, should be aware of what are considered to be normal childhood grief responses responses, the age appropriate response, as well as signs that a child may be having difficulty coping with the loss or death. Child and adolescent psychiatrists report it is normal during the weeks following the death for some children to feel immediate grief or persist in the belief that the family member is still alive. However, long-term denial of the death or avoidance of grief can be emotionally unhealthy and can later lead to more severe problems. Knowing what is outside the range of the normal grief response makes it easier to determine when it is time to seek professional help. (See "When to Seek Professional Help")

Some common ways children might respond to a death or loss include:

  • Sadness
  • Denial, shock and confusion
  • Anger
    • At the person who died.
    • At the surviving parent.
    • At doctors and nurses for not saving the life of the person who died.
    • At God, self and life.
  • Inability to sleep
  • Nightmares
  • Loss of appetite
  • Fear
    • Of being alone.
    • That the other parent will die.
    • That they will die.
    • Of hospitals and doctors.
    • Of getting lose to others who might die.
  • Physical complaints such as stomachaches and headaches
  • Loss of concentration
  • Guilt
    • Over failure to prevent the loss.
    • That they caused the sickness, illness, tragedy or death.
    • That they could not save the person from dying.
    • That they are having fun while someone else is sick, dead or dying.
  • Depression or a loss of interest in daily activities and events
  • Acting much younger for an extended period or reverting to earlier behaviors (e.g., bedwetting, “baby talk” or thumb-sucking)
  • Boisterous play
  • Withdrawal from friends and activities.
  • Sharp drop in school performance or refusal to attend school.
  • Excessively imitating or asking questions about the deceased or making repeated statements of wanting to join the deceased.
  • Yearning and pining for the deceased.
  • Difficulty or unwillingness to talk about the events or the deceased.
  • Inventing games about dying.
  • Searching for the dead person.
  • Profound emotional reactions (e.g., anxiety attacks, chronic fatigue or thoughts of suicide)
American Academy of Child and Adolescent Psychiatry. Fast Fact # 8. Children and Grief. Updated November 1998. Available at: Site.
National Mental Health Association. Helping Children Cope With Loss. 2001. Available at: Site.
Doka KJ, ed. Living with Grief: Children, Adolescents, and Loss. Washington D.C.: Hospice Foundation of America, 2000.
American Academy of Child and Adolescent Psychiatry. Fast Fact # 36. Helping Children After a Disaster. Updated March 2000. Available at: Site.
National Institute of Mental Health. Helping Children and Adolescents Cope with Violence and Disasters. Available at: Site.

Because children and teens grieve differently than adults, their needs, especially support through the grieving process, are often overlooked. Consequently, children and teens are frequently forgotten, even invalidated, as mourners.

Kirsti A. Dyer, MD, MS
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Last update Sept. 11, 2002